title: Comparison of dorzolamide/timolol versus brimonidine/timolol fixed combination therapy in the management of steroid-induced ocular hypertension.
abstract: OBJECTIVE
  To compare the efficacy of fixed combinations of dorzolamide-timolol (FCDT) and brimonidine-timolol (FCBT) in patients with intraocular pressure (IOP) elevations after intravitreal triamcinolone acetonide (IVTA) injections.
  
  
  METHODS
  This was a prospective, randomized, open-label study. Patients who received IVTA injections due to diffuse diabetic macular edema and who had an IOP of 24 mm Hg or higher after IVTA treatment were included. They were randomized to receive either FCBT or FCDT twice daily. Follow-up visits were scheduled on week 4 and 12 weeks after starting the study medication. At all follow-up visits, IOP was measured with Goldmann applanation tonometry. The primary outcome measure was mean IOP, the secondary outcome was reduction in mean IOP at 4 and 12 weeks compared with postinjection values.
  
  
  RESULTS
  Sixty patients were randomized in 1:1 ratio. The FCBT and FCDT groups were similar in terms of age, sex, and preinjection IOP (P>0.05 for all). Mean postinjection IOP was 31.95±7.39 and 29.83±5.17 mm Hg in FCBT and FCDT groups, respectively (P=0.239). After 4 weeks, mean IOP was 17.05±3.61 mm Hg in FCBT and 18.93±3.30 mm Hg in FCDT groups (P=0.063). After 12 weeks, mean IOP in the FCBT and FCDT study groups was 16.35±2.70 and 18.43±2.82 mm Hg, respectively (P=0.012). Both fixed combinations significantly reduced IOP in comparison with the postinjection values (P<0.05). Mean reduction in IOP after 4 weeks were 14.90±7.28 mm Hg in FCBT and 10.90±4.83 mm Hg in FCDT groups (P=0.024); after 12 weeks, these values were 15.60±7.77 and 11.40±5.89 mm Hg in FCBT and FCDT groups, respectively (P=0.035).
  
  
  CONCLUSIONS
  Both FCBT and FCDT are effective in controlling IOP elevations after IVTA injections. The results of this study suggest that FCBT is superior to FCDT in reducing IOP and provides better IOP control after IVTA injections.
authors.affiliation: *Department of Ophthalmology, Medical Faculty, Celal Bayar University †Akhisar State Hospital, Department of Ophthalmology, Manisa ‡Horasan State Hospital, Department of Ophthalmology, Erzurum, Turkey.
authors.forename: Göktuğ
authors.initials: G
authors.lastname: Seymenoğlu
authors.forename: Esin F
authors.initials: EF
authors.lastname: Baser
authors.forename: Bilge
authors.initials: B
authors.lastname: Öztürk
authors.forename: Ceren
authors.initials: C
authors.lastname: Gülhan
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000068438:Brimonidine Tartrate; D003930:Diabetic Retinopathy / Q000188:drug therapy; D004338:Drug Combinations; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced / Q000188:drug therapy*; D011446:Prospective Studies; D011810:Quinoxalines / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*; D013999:Timolol / Q000627:therapeutic use*; D014065:Tonometry, Ocular; D014222:Triamcinolone Acetonide / Q000009:adverse effects*
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D005938:Glucocorticoids; D011810:Quinoxalines; D013449:Sulfonamides; D013876:Thiophenes; C479140:dorzolamide-timolol combination; D000068438:Brimonidine Tartrate; D013999:Timolol; C062765:dorzolamide; D014222:Triamcinolone Acetonide